Correlation Between Virtual Histology Features Of Atherosclerotic Plaques In Patients With Coronary Disease And High Sensitivity C-reactive Protein Or Lipoprotein-associated Phospholipase A2

ObjectivesTo evaluate the vulnerability of coronary atherosclerotic plaques in patients with coronary disease by intravascular ultrasound gray imaging and virtual histology(IVUS-VH) ; To assess relationship between IVUS-VH features of coronary atherosclerotic plaques and high sensitivity C-reactive protein (hs-CRP) or lipoprotein-associated phospholipase A2 (LP-PLA2)in patients with coronary disease.Metheods120 patients with coronary artery disease were divided into acute coronary syndrome group (39 males, 12 females, aged 63±10) and stable angina group (28 males, 11 females, aged 63±9)and control group (23 males, 7 females, aged 59±7). Hs-CRP and LP-PLA2 were measured and compared among 3 groups and coronary angiography (CAG) were performed in all patients. IVUS (gray imaging and virtual histology) was used to analysis 30 patients. The minimum lumen area (MLA) was selected to measure cross section area, (CSA) and external elastic membrane area (EEMA), to calculate plaque area, percentage stenosis of the MLA site, remodeling index (RI) , eccentricity index (EI), plaque burden. The composition and character of plaques were accessed by IVUS-VH soft ware. The results were analyzed by correlate analysis.Results 1. Comparison of hs-CRP and LP-PLA2 in patients among 3 groupsThe levels of plasma hs-CRP and LP-PLA2 in ACS group were higher than those in SAP group(P<0. 05), The levels of plasma hs-CRP and LP-PLA2 in SAP group were higher than those in control group (P<0. 05). The levels of plasma hs-CRP and LP-PLA2 in vulnerable plaque group were higher than those in stable plaque group(P<0. 05).2. Correlation of the remodeling index and plaque vulnerabilityIVUS found that patients in ACS group had unstable soft lipid plaques, but patients in SAP group had stable fiber plaques (P<0. 01). Lesions with RI≥1. 05 were considered to have positive remodeling and lesions with RI≥0.95 were considered to have negative remodeling. Lesions with RI≥1.05 had a significantly larger lipid core than lesions with RI0. 96-1. 04 and RI≤0. 95(9. 78±7. 84v3. 67±2. 31v23. 3±9. 62, respectively, P=0. 001). A positive correlation between lipid core and RI (r=0.627, p <0. 001).3. Correlation of hs-CRP and plaque vulnerabilityA positive correlation between hs-CRP and lipid core (r=0.404, p=0. 027), hs-CRP and RI (r=0. 367, p=0. 027).4. Correlation of LP-PLA2 and plaque vulnerabilityA positive correlation between LP-PLA2 and lipid core (r=0.419, p=0.021), LP-PLA2 and RI (r=0. 462, p=0. 01).Conclusions1. Plasmal levels of hs-CRP and LP-PLA2 are significantly increased in patients with ACS and vulnerable plaques.2. Patients with stable angina usually have stable plaques with vessel negative remodeling, and conversely patients with ACS frequently have vulnerable plaques with vessel positive remodeling.3. Plasmal levels of hs-CRP and LP-PLA2 are correlated with lipid core size and RI. 4. LP-PLA2 may be a sensitive parameter for predicting vulnerable plaques with more accuracy than hs-CRP.